[Emphasizing ocular surface status management throughout the course of glaucoma diagnosis and treatment]

Glaucoma is a major cause of irreversible blindness worldwide, and patients often require long-term or even lifelong topical intraocular pressure-lowering therapy. With prolonged treatment, the combined effects of active drug ingredients, preservative exposure, age-related ocular surface changes, and surgery-related factors make ocular surface disease a common yet easily overlooked comorbidity in patients with glaucoma. Ocular surface abnormalities may cause ocular discomfort and fluctuating vision, reduce medication adherence, interfere with intraocular pressure measurement and disease assessment, increase the difficulty of perioperative management, and affect long-term treatment efficacy and quality of life. This article emphasizes the need to change the clinical tendency of focusing on intraocular pressure while neglecting the ocular surface, and to incorporate ocular surface assessment and intervention into the entire course of glaucoma diagnosis and management. While protecting the optic nerve, clinicians should also maintain the homeostasis of the ocular surface microenvironment, thereby promoting long-term individualized management of glaucoma.